February 22, 2013
Dear Mayo Clinic:
How can you tell if a wound requires a trip to the doctor?
Knowing when a wound needs medical attention and when it can be managed at home is not always simple. A variety of factors make a difference in how serious a wound may be and whether a doctor should evaluate it. If you are in doubt, seek medical care.
A wound's location is one of the first things to consider. Any wound in an area that has vital organs, even if the wound is small, should be evaluated. In most cases, doctors also want to see wounds to the hands and feet, especially puncture wounds. Because of the large number of nerves, tendons and blood vessels packed into small spaces within your hands and feet, a wound to these areas can cause a great deal of damage. For the same reason, wounds near a joint should also be assessed by a medical professional.
It is important to see a doctor for any wound that involves the face. Not only are there vital structures within your face that need to be protected, but the sooner a wound is treated, the lower the risk of permanent facial scarring.
Consider the symptoms you have, too. Obviously, most wounds involve pain and bleeding. If there is a lot of bleeding or if bleeding is hard to stop, go to an emergency department. If the wound is extremely painful, that also requires a doctor's care. If you have numbness associated with a wound, it could mean you have nerve damage. Those types of injuries need to be medically evaluated. Wounds in which the skin is pulled apart may require stitches.
When deciding if you need medical care, you also should factor in how you got the wound. Wounds that may be contaminated are at high risk for infection and need to be treated by a medical professional. For example, injuries from farm equipment are more likely to become contaminated, due to the way that equipment is used.
Also, if you receive any wound â€” large or small â€” from something that may have dirt, rust or animal feces on it, and you are not certain if your tetanus shot is current, seek care right away. Tetanus, a serious disease that can affect your nervous system, is caused by bacteria entering your body through a wound.
In addition, any wound caused by a bite that breaks the skin â€” either an animal bite or a human bite â€” must be evaluated by a doctor as soon as possible. The mouth harbors many organisms that can cause infection.
If you consider all these factors and decide a wound does not need medical attention, there are still several self-care steps you should take to ensure proper healing. First, no matter how a wound happens, you need to wash it out. The best way to do that is simply to put it under running tap water. You can use a saline solution, if you prefer. But, as long as your faucet is clean, tap water works just as well.
After a wound is clean, cover it with a small amount of antibiotic ointment and put a bandage over it. Some people put antiseptics like hydrogen peroxide or alcohol on wounds. That is not a good idea, for two reasons. First, some antiseptics are extremely painful on an open wound. Second, they can actually damage your body's tissue, causing the injury to become more severe.
If you opt for self-care, keep an eye on your wound. If the area around the wound becomes red or begins to swell, or pus begins to drain from it, seek medical care right away. If you notice any numbness developing around the wound, that should be checked by a medical professional, too.
â€” Annie Sadosty, M.D., Emergency Medicine, Mayo Clinic, Rochester, Minn.